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Lifestyle Tips for Cancer Prevention

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It has been estimated that nearly half of the deaths due to cancer in 2017 could have been prevented. While much progress has been achieved in the diagnostics and treatment of a wide range of cancer types over the past decade, prevention remains the most impactful way individuals can stem the risk of contacting the deadly disease.

It is common and universally accepted knowledge that smoking or using tobacco products significantly increases the likelihood of getting cancer, and efforts to increase awareness of the health related risks of tobacco use has had an impact on the occurrences of lung and other respiratory cancers. Some studies are indicating that rising levels of obesity due to inactivity and sedimentary lifestyles are having an unfavorable effect on the rise in esophagus, colorectal, breast, endometrium and kidney cancers.

Diets high in fruits and vegetables have shown to be effective against many cancers. Regular physical activity and the maintenance of a healthy body weight, along with a healthy diet, considerably reduce cancer risk. Reducing alcohol use, avoiding environmental pollution, limiting occupational exposure to known carcinogens and careless exposure to radiation are other factors that will impact the risk of getting cancer.

The World Cancer Research Fund (WCRF) is making its cancer prevention recommendations in order to help people live cancer-free lives and to encourage public policies that reduce the incidence of cancer more widely. “Our Cancer Prevention Recommendations come from our latest Expert Report and from the conclusions of an independent panel of experts – they represent a package of healthy lifestyle choices which, together, can make an enormous impact on people’s likelihood of developing cancer and other non-communicable diseases over their lifetimes,” says Professor Martin Wiseman, Medical and Scientific Adviser. The recommendations help people reduce the risk of developing cancer and are based on the latest science available.

“The Cancer Prevention Recommendations are the centerpiece of our new report,” says Dr. Kate Allen, World Cancer Research Fund International’s Executive Director of Science & Public Affairs. “They form a global blueprint, a package that people can follow to help reduce their risk of cancer. They are useful to scientists because they can help determine future directions of research. They are useful to policymakers because they can inform the development of policy to help people follow them. They are useful to communities and families and individuals to help them reduce their cancer risk, and also to cancer survivors to highlight the best ways to further reduce their cancer risk. They are also helpful to health professionals in their work with cancer patients and the general public.”

The well-worn adage, “An ounce of prevention is worth a pound of cure” is sage advice when attempting to lower the risk of getting cancer.

American Cancer Society Updates Colon Cancer Screening Recommendations

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Colorectal Cancer is the fourth most common non-skin cancer in the United States and the second leading cause of death due to cancer. Generally colorectal cancer most impacts those over age 50, but recent studies have revealed that the number of cases in young people has increased 51 percent since 1994. Andrew Wolf, an associate professor of medicine at the University of Virginia says, “We don’t know why it’s going on, but it’s increasingly clear that it is happening.” Most of the nation’s 140,000 annual cases and 50,000 deaths from colon and rectal cancer still occur among people over age 55, but the share of cases involving younger adults is concerning.

Some researchers believe the consistent rise in colon cancer in younger Americans is the result of poor diet and obesity. Whatever the cause, the result of recent studies has led the American Cancer Society to reevaluate its long-standing guidelines on colon cancer screening.  While the overall costs and benefits of earlier screening remain a topic of debate within the cancer care community, the message that early screening is important rings true. David Weinberg, chairman of medicine at Fox Chase Cancer Center in Philadelphia says, “The bottom line is that if you regularly participate in colon cancer screening, you have a reduced risk of getting and dying from colon cancer.”

The American Cancer Society (ACS) is now recommending that all adults at average or low risk get screened for the disease at the age of 45, instead of 50 as it previously recommended. Those in good health, at average risk, and who have a life expectancy of more than 10 years should continue screening through the age of 75. Men and women at high risk, such as patients with a family history of colorectal cancer, may require a more aggressive screening program.

A colonoscopy has long been the most common form of testing a patient for colorectal cancer but is a procedure that many avoid or delay. New prescreening solutions are now available which can alleviate the discomfort of the pretest requirements. Several other tests are available by prescription, including stool tests that can be administered at home, eliminating the time spent in a clinic or hospital and the risk of bowel perforation and complications from anesthesia.

The professional staff and Oncologists at Gettysburg Cancer Center (GCC) understand the importance of prevention as well as treatment of cancer. With Medical Oncology, Radiation Oncology, Diagnostic Imaging and an onsite laboratory and pharmacy, GCC offers comprehensive screening and treatment options.

Genetic Testing for Cancer, is it the Right Decision for You?

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Knowing something is almost always better than not knowing. Cancer will impact one in three people over their lifetime; a statistic that suggests that contacting the deadly disease is a matter of random chance. Knowledge that one is in the “more likely to get” column can be seen as good news, resulting in closer monitoring and additional testing that could potentially lead to earlier discovery and therefore an increased chance of treatment and survival.

Most cancer risks are directly related to personal behaviors such as using tobacco or over exposure to the sun or other cancer-causing substances and activities. Family cancer syndrome (inherited cancer) can occur when inherited gene mutations that are passed from generation to generation increase the odds of contracting the disease. Only about 5% to 10% of all cancers are thought to result directly from gene mutations inherited from a parent.

Family history of the same type of cancer; cancers developing at earlier ages; multiple family members contacting identical or rare cancers or cancers experienced in multiple generations are some cancers thought to be indicative of family cancer syndrome. Cancer occurrence within close relations is more cause for concern than those in distant relationships. For some rare cancers, the risk of a family cancer syndrome is relatively high with even one case. Some types of cancers have no known mutations linked to an increased risk and others may have known mutations, but no way to test for them.

Genetic testing can be performed by either a blood or cheek swab sample and do not detect whether a person has cancer; testing indicates whether a person carries a change in one of their genes which can increase cancer risk. Most people will not benefit from genetic testing for cancer, but those who have a strong indication of family gene mutations may be able to take actions that lower the risk of the disease.

BRCA1 and BRCA2 are the most common genes involved in hereditary breast and ovarian cancers and a positive connection to these genes can also indicate a higher risk for other cancers, but nearly 85% of breast cancers occur in women who have no family history of the disease. No genetic test can determine whether a person will develop cancer with certainty.

The results of genetic testing can be beneficial in making medical decisions for cancer treatment, additional screening and prevention. Selecting the correct test and interpreting the results accurately can be complex, and the decision to have the test may impact personal relationships with other family members. For these reasons, the decision to undergo genetic testing is a very personal one, and one that should be made after considering all unique circumstances.

Availability of Oral Chemotherapy Drugs on the Rise

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When we think about chemotherapy (chemo) treatment for cancer, more often than not we harbor visions of intravenous (IV) injections of chemicals with complicated names, usually being administered in sterile medical environments with the patient surrounded by attending oncology professionals. But advances in chemotherapy drugs over the past decade are quickly changing the perceptions most of us have developed about chemotherapy and how it is administered. The fact that chemotherapy is available in oral (pill) form for numerous types of cancer is a surprise to many. In fact, an estimated 30% of cancer drugs in development are oral, and the trend is increasing.

With cancer survival rates consistently increasing over the past decade, cancer is becoming a chronic illness for cancer patients. The ability to receive extended cancer therapy protocols at home and by mouth is beneficial in time, convenience and cost that accompanies typical IV administered treatments. Oral anticancer medications (OAMs) have become available to treat many different cancers, including lung, leukemia, colorectal, kidney, and prostate and have been shown to be as effective as other forms of treatment. “The efficacy of chemotherapy pills … are similar to the traditional intravenous therapy, with research showing that the overall survival with oral chemotherapy is the same as patients would have with traditional intravenous chemotherapy,” says Dr. Hannah Luu, California-based oncologist and CEO and founder of OncoGambit.

However, OAMs shift much of the responsibility for proper administration from attending medical professionals to the patient and family members. Dr. Luu cautions, “Chemotherapy pills have the potential to cause the same serious toxicities as intravenous chemotherapy. If used incorrectly, they can potentially have fatal outcomes. It’s important for patients to be aware of their treatment plan and take their chemotherapy drugs accordingly. It’s even more important that the patient doesn’t take the missed pills with the next dose.”

Doctor appointments are still necessary with the use of OAMs, to perform regular scans or blood tests to ensure the medication is working safely and effectively. Handling of these oral medications requires careful attention as well as consistent adherence to the treatment regimen. Not skipping doses is critical to effective treatment.

A recent study showed that both providers and patients face barriers from insurance carriers on the use of OAMs. Some insurers cover OAMs as a prescription drug benefit, rather than a medical procedure. Delays in getting approval may be labor intensive and take several weeks. Out-of-pocket costs can vary and may require additional administrative support to overcome.

Gettysburg Cancer Center, a leader in oncology care across south central Pennsylvania since 1989, is dedicated to providing all-encompassing oncology and hematology programs and a complete range of diagnosis, treatment, and follow-up care for patients. For more information call (717) 334-4033.

Immunotherapy Drug Is Providing Exciting Results in the Treatment of Lung Cancers

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Alex was in his early 40s when he was diagnosed with Stage 4 Lung Cancer. A non-smoking, healthy man, who exercises regularly and eats relatively well is not who most people think of when they think of lung cancer.  However, people exactly like Alex are the new faces of lung cancer diagnoses. Alex is also one of a select few who qualified for a new targeted therapy drug recently approved by the FDA.

Lung cancer is the leading cause of cancer death globally, causing 1.7 million deaths a year. In the United States, it is expected to kill more than 154,000 people in 2018, but recent studies are producing credible progress in finding new drugs that, when combined with more traditional chemotherapy, are greatly improving the survival rates among lung cancer patients. The findings are dramatically changing the way physicians are treating lung cancers. “What it suggests is that chemotherapy alone is no longer a standard of care,” said Dr. Leena Gandhi, a leader of the study and director of the Thoracic Medical Oncology Program at the Perlmutter Cancer Center at New York University Langone Health.

So far, four drugs called checkpoint inhibitors, which unleash the patient’s own immune system to kill malignant cells, have been approved by the FDA. “I’ve been treating lung cancer for 25 years now, and I’ve never seen such a big paradigm shift as we’re seeing with immunotherapy,” said Dr. Roy Herbst, Chief of Medical Oncology at the Yale Cancer Center.

In the trial, patients with metastatic nonsquamous non-small cell lung cancer (NSCLC) who received the drug pembrolizumab (Keytruda) plus chemotherapy had improved overall survival and progression-free survival compared with just chemotherapy alone.  The results from the KEYNOTE-189 clinical trial were presented at the annual meeting of the American Association for Cancer Research (AACR) in Chicago on April 16 and published concurrently in the New England Journal of Medicine.

One of the main factors in the high rate of death due to lung cancer is that the disease is most often undetected until it has spread to other organs of the body. Lung cancer is the second most prevalent form of cancer in men and women and the top cancer killer among both sexes. In addition to the encouraging results from immunotherapy drugs, a newly discovered protein is showing promising results in detecting lung cancer earlier, providing new advanced treatment options to patients at the earliest stages of the disease. “The use of CKAP4 as a biomarker could change current practices regarding the treatment of lung cancer patients, and the diagnostic accuracies may be markedly improved by the combination of CKAP4 and conventional markers,” says Yuichi Sato, Division of Molecular Diagnostics, Kitasato University.

While the news of earlier discovery and new treatment options is very good, reducing risk factors for the disease remains the best approach to avoiding cancer. Exposure to tobacco smoke is one of the leading causes of lung cancer. Smoking marijuana and using electronic cigarettes may also increase the risk of lung cancer, but the actual risk is unknown. People who work with asbestos in a job such as shipbuilding, asbestos mining, insulation, or automotive brake repair and who smoke have a higher risk of developing cancer of the lungs. Exposure to radon has been associated with an increased risk of some types of cancer, including lung cancer. Having your home tested for the presence of Radon is a good and economical method for reducing the risk. Some people also have a genetic predisposition for lung cancer. People with parents, brothers, or sisters with lung cancer could have a higher risk of developing the cancer themselves.

Understanding cancer and how to treat it is constantly evolving toward the day when a cure is discovered. The cure is not here yet, but treatment options have greatly improved in recent decades. The treatments and methods used in clinical trials are promising in every environment in which they are tested. For more information on advancements in cancer detection and treatment, visit https://gettysburgcancercenter.com/.

What is Your Cancer Stage and Why is it Important to Know?

 

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One of the many new terms that patients hear when receiving a cancer diagnosis is “stage”. Along with a long list of other medical terminology used by caregivers to describe cancer, the stage of cancer is used to describe the level at which the cancer has progressed. The stage of cancer will determine where the disease is located, if or where it has spread, what other parts of the body it may have affected, and the patient’s estimated survivable rate. The stage is the most credible indication of the cancer’s progression at a given period of time and is determined by patient procedures and tests such as physical examinations, imaging scans, biopsies, blood tests, surgery or other genetic testing. Even though this is extremely important information, nearly half of the patients diagnosed with cancer in the past two years are unaware of their disease’s stage.

The American Joint Committee on Cancer (AJCC) recently released the latest edition of its cancer staging manual with new and updated staging for many types of cancer. Most cancer treatment centers started using the updated manual on January 1, 2018.

The specific stage of cancer can be determined by tests conducted prior to diagnosis or after a surgery has been performed. It can provide answers to questions concerning the size of the primary tumor, whether it has spread to the lymph nodes or other parts of the body and if the cancer is more or less likely to spread. The cancer’s stage will help determine the specific course of treatments, establish the likelihood of recovery, the estimated time to recovery and permit the patient to develop a roadmap for the challenges that lie ahead.

Most types of cancer have four stages:

  • Stage 0 is the stage that best describes cancer that is still located in the place it started and has not spread to nearby tissues. This stage of cancer is often highly curable, usually by removing the entire tumor with surgery.
  • Stage I cancer is usually a small cancer or tumor that has not grown deeply into nearby tissues. It also has not spread to the lymph nodes or other parts of the body and is often referred to as early-stage cancer.
  • Stage II and Stage III refers to larger tumors that have grown more deeply into nearby tissue and those that may have spread to the lymph nodes but not to other parts of the body.
  • Stage IV indicates that a cancer has spread to other organs or parts of the body and is sometimes called advanced or metastatic cancer.

Understanding your cancer stage will provide critical insight on your future treatment options, the time and direction of recovery and ultimately your likelihood for survival. It is important to be informed about all aspects of your disease so that you can be an active and well-informed participant in your own care.

Understanding the Nexus of Aging and the Increase in Cancer Risk

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As Americas’ Greatest Generation continue to age studies are revealing that with the increase in the age of the population comes an increase in cancer risk. The nexus of age and cancer is supported by National Cancer Institute (NCI) research. The convergence of an overall aging population and a peak cancer incidence among those aged 65 to 74 will result in a significant rise in the number of people diagnosed with cancer. In addition, as people age the types of treatments and the eligibility and ability for older patients to participate in clinical trials diminishes.

According to the most recent statistical data from NCI’s Surveillance, Epidemiology, and End Results program, the median age of a cancer diagnosis is 66 years. The median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer, and 66 years for prostate cancer.

Healthcare professionals treating older cancer patients often discover other health conditions that may limit the use of specific therapies. Unless there is sufficient evidence that older patients can benefit from standard dosage of some therapies, clinicians can be reluctant to give older patients potentially beneficial treatments. This practice of less intensive therapy in aging patients is historically understandable; however, a growing field of geriatric oncologists now consider chronological age insufficient evidence for denying aggressive cancer therapy.

The solution to this aging dilemma, like the disease, is complex and we need to better understand how the biological underpinnings of aging affect the onset and trajectory of cancer. Reasons for this increase of cancer with aging can be contributed to the fact that living longer increases our exposure to things that have been shown to be contributing factors in determining cancer risk, such as exposure to sunlight, radiation, environmental toxins and noxious by-products of metabolism that increase with age. “Most aging cells develop genomic changes that make them more susceptible to the carcinogens in the environment,” says oncologist Lodovico Balducci, who studies and treats cancer in the elderly at the Moffitt Cancer Center in Tampa, Fla. In addition, the various immune defenses that keep our tissues healthy begin to break down with age.

Some of the more serious health conditions that are more common in adults over 65 that may impact the response to a cancer diagnosis include; high blood pressure, heart disease, lung disease, diabetes, kidney disease and arthritis. These co-existing conditions must be taken into account when designing cancer treatment protocols for older patients. For those older patients with cancer, knowing how treatments will be affected by these contributing factors is important to understanding how to respond to the process of therapy.

But progress towards better understanding is underway. A joint collaborative effort with the National Institute on Aging (NIA) and the Samuel Waxman Cancer Research Foundation is underway which will promote and support interdisciplinary research projects, sharing of resources, and development of new technologies and approaches to better understand how the physiological changes associated with aging affect cancer development, progression, and response to therapy. NCI is also committing more resources aimed to increase enrollment for older patients in clinical trials.

Cigarette Smoking a Leading Cause of Preventable Death in United States

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On the last Sunday in November 2017, television viewers and print media readers experienced a dramatic moment that continues into this year. The three major U.S. tobacco companies were ordered by the Federal Drug Administration (FDA) to issue the first in what will be a series of five “corrective statements” about their products. The corrective statements are the result of a federal racketeering lawsuit brought against the tobacco companies in 1999 by the Department of Justice. These court-ordered statements, which cover five different topic areas, explain in detail and in plain language the reality of the health harms inflicted by tobacco products upon users. Not that the harmful effects of cigarette smoking on a smoker’s health is anything new. Since the 1960’s, smokers and non-smokers alike have been bombarded with packaging warnings, public awareness campaigns and tobacco advertising bans. In case someone missed the multitude of discussions, the new statements should leave little doubt about the dangers of smoking tobacco.

Cigarette smoking is the leading cause of preventable death in the United States, causing nearly 30 percent of cancer deaths across the country. Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia. Among those, at least 69 can cause cancer. While we are all aware that smoking causes cancer, smoking also harms nearly every bodily organ and organ system in the body and diminishes a person’s overall health. Among the cancers caused are: lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia. Smoking also causes heart disease, stroke, aortic aneurysm, chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, and cataracts, and worsens asthma symptoms in adults. There is no safe level of smoking. Smoking even just one cigarette per day over a lifetime can cause smoking-related cancers and premature death.

Despite all the good reasons to quit, kicking the smoking habit is extremely difficult. Studies show that most smokers picked up the habit as a teenager. Cigarettes contain various amounts of Nicotine, the highly addictive drug primarily responsible for a person’s addiction to tobacco products, so quitting can be very difficult even for those already diagnosed with cancer. A study by American Cancer Society researchers found that about 1 in 10 cancer survivors still reports smoking about 9 years after a cancer diagnosis. Lead author Lee Westmaas, PhD, American Cancer Society Director of Tobacco Control Research, says, “Doctors and health care providers must continue to ask survivors about their smoking and provide resources, including medications and counseling, to help them quit.”

Cessation has immediate benefits to a smoker. Ex-smokers suffer from fewer illnesses, lower rates of pneumonia and are healthier overall than people who continue to smoke. Regardless of age, smokers can substantially reduce their risk of bad health. Smokers who quit before age 40 reduce their chance of dying prematurely from smoking-related diseases by about 90%, and the reduction for those who quit by age 45-54 is about two-thirds.

The National Cancer Institute (NCI) and other agencies and organizations can help smokers quit. For more information on organizations that can help you quit smoking, contact the NCI Smoking Quitline at 1–877–44U–QUIT (1–877–448–7848) for individualized counseling, printed information, and referrals to other sources.

Proper Screening and Lifestyle Changes Can Impact Cancer Risk

GCC February Blog Image 2 (640x427)When Cheryl and her husband of thirty-five years sold their business and headed off to retirement, they looked forward to having more time to dedicate to their three children and four grandchildren. Discovering a lump in her left breast while on vacation dramatically altered their retirement plans and her outlook on the future. With no family history of breast cancer, the results of her mammogram were stunning. Cheryl was diagnosed with Stage 2 triple negative ductal carcinoma breast cancer.

Cheryl is not unlike many thousands of women who receive an unexpected breast cancer diagnosis. While aware of the disease and its impact on the lives of those suffering from it, the thought of receiving the bad news is one stuck in the back of the mind, hopefully never to be realized.

In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 63,960 new cases of non-invasive breast cancer. Death rates have been decreasing since 1989, but approximately 40,920 women in the U.S. are expected to die in 2018 from breast cancer. About 85% of breast cancers occur in women who have no family history of breast cancer. The two most common risk factors are gender and growing older. While you can’t change some breast cancer risk factors there are some risk factors that you can control.

Personal behaviors, such as diet and exercise, and taking medicines that contain hormones can impact the chances of getting breast cancer. Drinking alcohol is clearly linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Being overweight or obese increases the risk in women after menopause. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity. Moderate and vigorous physical activity lowers risk for postmenopausal breast cancer. Vigorous physical activity lowers risk for pre-menopausal breast cancer, according to the recently released American Institute for Cancer Research “Breast Cancer Report.”

Early detection of breast cancer is the leading factor in the historic decline in cancer deaths. With screening mammography, treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74.

“The importance of love and life hits you square in the face and it takes a strong toll on your body and spirit,” says Cheryl of her diagnosis and treatment regimen.  Today she is more than one year cancer free.

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting close to home. The all-encompassing oncology and hematology programs provide a complete range of diagnosis, treatment, and follow-up care for all types of cancer.

October is Breast Cancer Awareness Month Around the World

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Billed as the most common cancer in women, breast cancer is impacting the lives of one in eight women in the United States. The second leading cause of cancer death in women after lung cancer, breast cancer most commonly occurs in women 50 years of age and older. Breast cancer is caused by a genetic mutation in the DNA of breast cancer cells but how or why this damage occurs isn’t fully understood. Some mutations may develop randomly over time, while others are inherited or may be the result of environmental exposures or lifestyle factors. More than 3.5 million women are living in the U.S. with a history of breast cancer.

Early detection remains the most important factor in the successful treatment and survivability of breast cancer. Caught early when known treatments have the best chance of success, breast cancer is survivable. Successful treatments include surgery, chemotherapy, radiation and immunotherapy. “Risk factors include being female, obesity, a lack of physical exercise, drinking alcohol, hormone replacement therapy during menopause, ionizing radiation, early age at first menstruation, having children late or not at all, older age, and family history.” With the clear lack of knowledge for its causes, early detection of the disease remains the cornerstone of breast cancer control.

National Breast Cancer Awareness Month (NBCAM) was founded in 1985 by the American cancer Society and what is now known as AstraZeneca Pharmaceuticals. Held each October, the event is an attempt to increase the awareness of breast cancer and to aid the solicitation of funds for research and treatment of the disease. NBCAM unites cancer organizations around the world in providing information and support for those suffering from the cancer. Breast Cancer Awareness is represented by the display of pink ribbons, first introduced by the Susan G. Komen Foundation at its New York City race for breast cancer survivors in 1991.

The effort by so many to bring worldwide attention to the disease appears to be having a positive impact. A new report from the American Cancer Society finds that death rates from breast cancer in the United States have dropped 39% between 1989 and 2015. The overall declines in breast cancer death rates have been attributed to both improvements in treatment and early detection by mammograms. The American Cancer Society recommends women find breast cancer earlier when treatments are more likely to be effective. While there is a lack or definite agreement on when and how often screening is most effective, The National Comprehensive Cancer Network recommends annual screening beginning at age 40.

The professional team of oncologists and staff at Gettysburg Cancer Center supports the efforts of Breast Cancer Awareness Month in its world-wide goal to provide the latest information, research, treatment options and support for those who suffer from breast cancer.